Then-Gov. Bill Ritter decid­ed in 2010 that Colorado law allowed CRNAs to administer anesthesia to Medicare patients without supervision. The Colorado Medical Society and the Colorado Society of Anesthesiologists sued to overturn the governor’s decision, and the Denver District Court in 2011 granted a request by Gov. John Hickenlooper – Ritter’s successor – to dismiss the lawsuit. The Colorado Court of Appeals in 2012 sided with the governor.

In its brief, the AHA stated that the opt-out would improve access to care for rural residents.

“After proper consultation with the Colorado Medical Board and the Colorado Board of Nursing, the governor chose to make use of the latitude provided under Medicare to permit States to make full use of CRNAs without risking their hospitals being found ineligible for reimbursement,” the brief states. “Governor Ritter specifically tailored his decision to rural general and Critical Access Hospitals that face the challenges identified above. The optout will improve access to health care for rural Coloradans.”

Hospital governance ruling in Minnesota. On another legal issue, the AHA recently joined the Minnesota Hospital Association (MHA) in a friendof- the-court brief urging the Minnesota Supreme Court to uphold a lower court ruling that a hospital’s governing body can amend the bylaws governing the hospital’s medical staff.

“MHA and AHA members have an interest in both maximizing the prospect that they and their medical staffs can work together productively to advance the quality of health services delivery and ensuring that, in the rare instance when dysfunction… does arise, the hospital’s governing body is not powerless to effect needed improvements,” the brief states. “To that end, MHA and AHA urge that the ruling by the court of appeals should be affirmed on the two holdings that were essential to it: under Minnesota law, (1) bylaws governing a hospital’s medical staff may be amended by the hospital’s governing body; and (2) a hospital’s medical staff has no legal existence apart from the hospital such that it may bring suit against the hospital.”